HomeMy WebLinkAboutNo Permit Number (1593)1=1511golig"al:&gm
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
1 11
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
BUILDING
ADDRESS
LOCALITY
Diamond Bar
NEARESTCROSS
CITY ZIP
ST.
ASSESSOR
NO OF BLDGS 'NONE
SIZE OF LOT NOW ON LOT
MAP BOOK PAGE
PARCEL
31151
IBLOCK
DISTRICT
GROUP
TYPE
CONST.
FIRE
PROCESSED BY
TRACT
LOT N 65
0.
ZONE
OF SO, CAL ,F,TE
STATISTICAL CLASSIFICATION
SEWER MAP
OWNERPRESLE-Y NO."540-3611
ADDRESS P..O, Box 2200
2C) DWELL.0
USE ZONE CLASS NO, N I TS
MAP
B K PG
Newport Beach, CA 92663
CITY ,p -
NO.
O"RJakes�--j.(-tY�
ARCHITECT TEL.
979-1451
SPECAL
Cam r, NO.
COND�TIONS
ADDRESS 17915 Skypark Blvd.
ROAD DEPARTMENT APPROVAL REQUIRED YES[] NO
CONTRACTOR Same as owner NO, TEL..
BLDG, SETBACK FROM
LIC,
FRONT PROP. LINE OF
.(STREET)
ADDRESS NO. 289274
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
CITY LIC.
FRONT PROP. LINE
HIGHWAY WIDTH
CLASS B I
—
CONSTRUCTION LENDER
+
NAME AND BRANCH
BLDG, SETBACK FROM
ADDRESS CITY
SIDE PROP. LINE OF
(STREET)
SQ, FT, NO OF NO OF CHECK
1
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE 2525-1 STORIES 2 FAWLIES ONE
SIDE PROP. LINE
HIGHWAY WIDTH
Z-4-4-16, IV, Gar.-440-sq.ft.NEW
+
OF
DESCRIPTION WORK
ADD ❑
Sin e ami I y Dwql 1 i nq
CORNER CUTOFF YES ❑
N 0
I
Plan 41-3-B 4101, ALTER ❑
;S_�
IN OPEN SPACE YES ❑
NO ❑
—REPAIR0
USE OF 7.,1, cl q-
❑
IN COASTAL PERMIT ZONE YES ❑
No
EXISTING BLDG. DEMOL
APPLICANT TEL
(PRINT) NO.
BY (SIGNATURE)
I HEREBY ACK'NOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR ODE OF THE STATE OF CALIFORNIA IN RELATING TO
C WORKMEN'S CO MPEN: I URAN
SIGNATURE 7;�Trl
FINAL BY
PERMITTEE.
Campus D'r'-lve
DATE
ADEDRESS-400
TEL.
Newport Beach, CA 361
540-1
P.C. Fee $
Permit Fee
CITY NO.
Issuance Fee
4 6'j (_1
VALUATION C - 16''D
I
I
em�
Total Fee
PLAN CHECK VALIDATION
CK, M.O. CASH
0
PERMIT VALIDATION CK. M.O. CASH
76A638A CE:#803B 12/75